Continuous At-Home Monitoring of Nighttime Bed Behavior in Frontotemporal Dementia

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Background and Objectives: Sleep and circadian disturbances are common yet understudied in frontotemporal dementia (FTD). Advances in non-invasive digital monitoring technology enable capture of real-time objective nighttime behaviors in naturalistic settings. We examined feasibility and utility of an unobtrusive, under-the-mattress sensor to monitor long-term bed behaviors in a sample of adults with FTD and their study partners. Methods: Movement Monitor. Metrics were derived from each session in bed: duration in bed, time of bed-entry/exit, number of tosses/turns, and number of bed-exits. Bivariate relationships between baseline bed behaviors (aggregated across the first 30 days) and clinical characteristics (FTD vs. control; clinical dementia rating) were tested. Linear mixed-effects regressions examined longitudinal associations between baseline clinical severity and bed behaviors over time. To examine differential seasonal shifts in nightly bed behaviors, Fourier basis functions modeled nightly duration in bed over a full calendar year separately by clinical severity groups (controls vs. mild FTD vs. moderate-to-severe FTD). Results: <0.001). Discussion: Findings demonstrate the feasibility of long-term, non-invasive nighttime behavior monitoring using bed sensors, highlighting their utility to monitor disease progression in FTD with potential to detect person-specific changes and assess treatment effects. Further research is needed to explore underlying mechanisms of sleep disturbances in FTD and develop targeted interventions to improve sleep and subsequent quality of life for individuals with FTD.

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